Bill Text: CT HB05305 | 2010 | General Assembly | Comm Sub

Connecticut House Bill 5305 (Prior Session Legislation)

Bill Title: An Act Exempting From Regulation Certain Nonprofit Ambulance Services Or Companies.

Sponsorship: Partisan Bill (Democrat 1)

Status: (Introduced - Dead) 2010-03-31 - Tabled for the Calendar, House [HB05305 Detail]

Download: Connecticut-2010-HB05305-Comm_Sub.html

General Assembly		*Substitute Bill No. 5305*
*February Session, 2010*		_____HB05305PS____033110____

AN ACT EXEMPTING FROM REGULATION CERTAIN NONPROFIT AMBULANCE SERVICES OR COMPANIES.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Subsection (a) of section 38a-41 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2010):

(a) (1) No insurance company or health care center shall do any insurance business or health care center business within this state until and except while it is permitted to do so under the terms of a license issued by the commissioner. Any such company desiring to obtain such a license shall make application to the commissioner, setting forth the line or lines of business which it is seeking authorization to write. It shall file with the commissioner a certified copy of its charter or articles of association and evidence satisfactory to the commissioner that it has complied with the laws of the jurisdiction under which it is organized, a statement of its financial condition in such form as is required by the commissioner, together with such evidence of its correctness as the commissioner requires and evidence of good management in such form as is required by the commissioner. Applicant companies licensed in and operated from administrative offices in one state but domiciled in another state, as permitted by the applicable state law, shall provide justification of such arrangement, satisfactory to the commissioner, which shall demonstrate that regulatory influence of the domiciliary supervisory official has not been diminished as a result of such arrangement. An applicant shall demonstrate an orderly pattern of growth in its marketing territories in the geographic region, with the exception of a newly formed health care center, and an expertise in marketing and servicing the lines of insurance or the health care center business it desires to write. It shall submit evidence of its ability to provide continuant and timely claims settlement. If the information furnished is satisfactory to the commissioner and if all other requirements of law have been complied with, he may issue to such company a license permitting it to do business in this state. Each such license shall expire on the first day of May succeeding the date of its issuance, but may be renewed without any formalities except as required by the commissioner. Failure of a licensed company to exercise its authority to write a particular line or lines of business in this state for two consecutive calendar years may constitute sufficient cause for revocation of the company's authority to write those lines of business.

(2) A nonprofit ambulance service or company that provides emergency medical services on a subscription basis to residents of a municipality that (A) borders Rhode Island, (B) has a population of not less than eighteen thousand, and (C) occupies a total area of not less than fifty square miles, shall not be deemed to be engaged in the business of insurance if such services were being provided by such service or company to residents of such municipality on or before January 1, 2009.

Sec. 2. Subsection (a) of section 38a-479qq of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2010):

(a) As used in this section and section 38a-479rr:

(1) "Affiliate" means a person that directly or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, a health insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society licensed in this state;

(2) "Consumer" means: (A) A person to whom a medical discount plan is marketed or advertised, or (B) a member, as defined in this subsection;

(3) "Marketer" means a person that markets, advertises or sells a medical discount plan, including, but not limited to, an entity that markets, advertises or sells a medical discount plan under its own name;

(4) "Medical discount plan" means a business arrangement or contract in which a person, in exchange for payment, provides access for its members to providers of health care services and the right to receive health care services from those providers at a discount. "Medical discount plan" does not include a product that (A) is otherwise subject to regulation or approval under this title, or (B) costs less than twenty-five dollars, annually, in the aggregate;

(5) "Medical discount plan organization" means a person that (A) establishes a medical discount plan, (B) contracts with providers, provider networks or other medical discount plan organizations to provide health care services at a discount to medical discount plan members, and (C) determines the fees charged to the members for the medical discount plan. "Medical discount plan organization" does not include a health insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society licensed in this state or any affiliate of such health insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society;

(6) "Health care services" means any care, service or treatment of an illness or dysfunction of, or injury to, the human body. "Health care services" includes physician care, inpatient care, hospital surgical services, emergency medical services, ambulance services, dental care services, vision care services, mental health care services, substance abuse services, chiropractic services, podiatric services, laboratory test services and the provision of medical equipment or supplies. "Health care services" does not include (A) pharmaceutical supplies or prescriptions, or (B) ambulance services provided on a subscription basis by a nonprofit ambulance service or company to residents of a municipality that (i) borders Rhode Island, (ii) has a population of not less than eighteen thousand, and (iii) occupies a total area of not less than fifty square miles, if such services were being provided by such service or company to residents of such municipality on or before January 1, 2009;

(7) "Member" means an individual who pays for the right to receive the benefits of a medical discount plan; and

(8) "Person" means a person, as defined in section 38a-1.